Nonsurgical Redefinition of the Chin and Jawline of Younger Adults With a Hyaluronic Acid Filler: Results Evaluated With a Grid System Approach

2020 ◽  
Author(s):  
Dario Bertossi ◽  
Massimo Robiony ◽  
Andrea Lazzarotto ◽  
Giorgio Giampaoli ◽  
Riccardo Nocini ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Grid System ◽  
Level Of Evidence ◽  
Younger Adults ◽  
Lower Face ◽  
Age Related ◽  
Tissue Edema ◽  
The Face ◽  
The Mean ◽  
And Performance

Abstract Background Aesthetic treatment of the lower face is increasingly in demand, particularly owing to age-related changes in appearance. VYC-25L is a novel hyaluronic acid filler with high G′ and high cohesivity, specifically designed for sculpting and contouring of the chin and jaw. Objectives The aim of this study was to assess the use of a grid traced onto the chin and jaw for guiding treatment with VYC-25L. Methods This was a retrospective, single-center analysis of data from adult patients undergoing treatment of the lower third of the face with VYC-25L. A grid system of horizontal and vertical lines was used to systematize the process of treatment planning and performance. Results Thirty subjects were enrolled (53.3% female; mean [standard deviation] age, 34.4 [2.8] years). The mean quantity of VYC-25L used was 4.0 [0.8] mL. Based on the 5-point Global Aesthetic Improvement Scale, 29 patients (96.7%) rated their appearance at 20 days posttreatment as “much improved” or “very much improved.” The only complications recorded were early transient soft-tissue edema (n = 14; 46.7%) and bruising (n = 6; 20.0%). There were no cases of infection, paresthesia, asymmetry, hematoma, necrosis, or skin discoloration. Conclusions Treatment of the chin and jawline with VYC-25L, with injection locations determined by a standardized grid-based approach, appears to be effective and safe with high rates of patient satisfaction. Injection of this filler offers a potentially high-impact approach for patients across a variety of biological and economic circumstances. Level of Evidence: 4

scholarly journals VYC-25L Hyaluronic Acid Injectable Gel Is Safe and Effective for Long-Term Restoration and Creation of Volume of the Lower Face

2020 ◽  
Vol 40 (9) ◽  
pp. NP499-NP510 ◽  
Author(s):  
Patricia Ogilvie ◽  
Laurence Benouaiche ◽  
Wolfgang G Philipp-Dormston ◽  
Lakhdar Belhaouari ◽  
Frodo Gaymans ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Well Being ◽  
Controlled Study ◽  
Control Group ◽  
Level Of Evidence ◽  
Lower Face ◽  
Repeat Treatment ◽  
Acid Gel ◽  
Surgical Treatments ◽  
And Control

Abstract Background Juvéderm Volux (VYC-25L; Allergan plc) is an injectable hyaluronic acid gel designed to restore and create facial volume. Objective The aim of this study was to evaluate the safety and effectiveness of Volux for chin retrusion over 18 months and after repeat treatment. Methods This prospective, single-blind, controlled study enrolled subjects aged ≥18 years with chin retrusion (glabella-subnasale-pogonion facial angle 145°-165°). Subjects were randomized (3:1) to Volux at study onset or 3 months later (control group), and could receive a single repeat treatment during months 18 to 24. Assessments included mean facial-angle change from baseline, Global Aesthetic Improvement Scale (GAIS) responder rates (improved/much improved), improvements in 3 subject-reported FACE-Q scales, and safety. Results Of 132 enrolled subjects, 119 received initial Volux treatment and 89 received repeat treatment. Mean changes (95% confidence interval) in glabella-subnasale-pogonion angle from baseline for treatment and control groups, respectively, were: 1.15° (0.75°, 1.56°) and 1.16° (0.57°, 1.75°) at month 18, and 3.14° (2.68°, 3.61°) and 2.72° (1.78°, 3.66°) 1 month after repeat treatment. Investigators rated 52.5%/60.0% of treated/control subjects at month 18 and 96.9%/100% after retreatment as GAIS responders; subject-reported rates were 62.0%/64.0% and 93.8%/100%. Durable improvements in Satisfaction with Chin, Satisfaction with Lower Face and Jawline, and Psychological Well-Being were reported in 82.1%, 78.2%, and 60.3% of subjects, respectively, at month 18, and 92.3%, 93.8%, and 67.7% of subjects after retreatment. The safety profile was as expected. Conclusions Volux injectable gel is a safe, effective, and durable alternative to surgical treatments for increasing chin projection and jaw volume, and results in high patient satisfaction. Level of Evidence: 2

scholarly journals Local Infiltration of Tranexamic Acid With Local Anesthetic Reduces Intraoperative Facelift Bleeding: A Preliminary Report

2019 ◽  
Author(s):  
Rafael A Couto ◽  
Ali Charafeddine ◽  
Nicholas R Sinclair ◽  
Laxmeesh M Nayak ◽  
James E Zins
Keyword(s):  
Tranexamic Acid ◽  
Local Anesthetic ◽  
Level Of Evidence ◽  
Time Saving ◽  
Local Infiltration ◽  
Lidocaine Solution ◽  
The Face ◽  
The Mean ◽  
Time Required ◽  
The Right

Abstract Background Rebound bleeding as a result of loss of epinephrine effect is a common problem encountered during facelift surgery. Tranexamic acid (TXA) is an anti-fibrinolytic agent whose safety and efficacy in reducing bleeding are well documented. We have found that local infiltration of TXA combined with a lidocaine with epinephrine solution during facelift surgery has been effective in decreasing rebound bleeding and the time required to gain hemostasis. Objectives The authors sought to share their local infiltration protocol of TXA combined with epinephrine solution in facelift. Methods Patients who underwent facelift received subcutaneous injection of TXA-lidocaine 0.5% solution following the authors’ protocol. After completing both sides of the facelift and the submental platysmaplasty, the first and second sides were sequentially closed. The time to gain hemostasis on each side prior to closure was prospectively measured. Results Twenty-seven consecutive patients who underwent facelift surgery received local infiltration of TXA-lidocaine solution. In 23 of the 27 patients, the time required for hemostasis was prospectively recorded. The mean age was 62.1 years (±9.3) and all were females. The average time spent achieving hemostasis on the right, left, and both sides of the face was 6.5 (±2.7), 6.3 (±2.1), and 12.9 (±4.2) minutes, respectively. The total surgical time saving is approximately 25 to 60 minutes. Although primary facelift [13.6 (± 4.3)] exhibited a longer time of hemostasis compared with the secondary group [10.2 (± 2.8)], this was not statistically significant (P = 0.09). Conclusions Local infiltration of TXA with local anesthetic prior to a facelift appears to decrease bleeding, operative time, and postoperative facelift drainage output. Level of Evidence: 4

scholarly journals MD Codes™: A Methodological Approach to Facial Aesthetic Treatment with Injectable Hyaluronic Acid Fillers

2020 ◽  
Author(s):  
Maurício de Maio
Keyword(s):  
Patient Satisfaction ◽  
Hyaluronic Acid ◽  
Methodological Approach ◽  
Full Description ◽  
Injection Technique ◽  
Symbolic Language ◽  
Level Of Evidence ◽  
Delivery Technique ◽  
The Face ◽  
Facial Attributes

Abstract Background Patients often seek aesthetic correction of facial deficiencies (e.g., lines and folds) that are rarely the underlying cause of dissatisfaction with their appearance. Use of a more holistic approach focused on improving the emotional messages of the face (e.g., looking less sad) may improve patient satisfaction with treatment outcomes. The MD Codes™ system was developed to increase clinician success rates by reducing variability in the technical aspects of hyaluronic acid (HA) filler treatment and focusing on addressing unfavorable emotional attributes of the face. Methods The MD Codes, or medical codes, represent specific anatomical subunits for injection of HA fillers. Each MD Code includes information regarding the target depth of injection, the proper delivery tool (needle or cannula) and delivery technique (e.g., aliquot, bolus, fanning), and the minimum product volume recommended to achieve visible, reproducible results (active number). During treatment planning, the appropriate MD Codes are selected using algorithms focused on lessening unfavorable facial attributes (a saggy, tired, sad, or angry look) and enhancing positive attributes (an attractive, younger, more contoured, or feminine [soft] or masculine look). Results Three case studies are presented to illustrate how the MD Codes and their algorithms were used to address sagginess, tiredness, and sadness in two women and one man. Conclusions MD Codes provide a universal symbolic language for reducing variability in injection technique. The platform provides user-friendly algorithms to help clinicians increase patient satisfaction by going beyond treatment of lines and folds and to focus on reducing unfavorable facial attributes. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Stimulus Specific to Age-Related Audio-Visual Integration in Discrimination Tasks

i-Perception ◽  
2020 ◽  
Vol 11 (6) ◽  
pp. 204166952097841
Author(s):  
Yanna Ren ◽  
Zhihan Xu ◽  
Sa Lu ◽  
Tao Wang ◽  
Weiping Yang
Keyword(s):  
Older Adults ◽  
Time Window ◽  
Response Times ◽  
Race Model ◽  
Compensatory Mechanism ◽  
Younger Adults ◽  
Visual Integration ◽  
Age Related ◽  
Significant Difference ◽  
The Mean

Age-related audio-visual integration (AVI) has been investigated extensively; however, AVI ability is either enhanced or reduced with ageing, and this matter is still controversial because of the lack of systematic investigations. To remove possible variates, 26 older adults and 26 younger adults were recruited to conduct meaningless and semantic audio-visual discrimination tasks to assess the ageing effect of AVI systematically. The results for the mean response times showed a significantly faster response to the audio-visual (AV) target than that to the auditory (A) or visual (V) target and a significantly faster response to all targets by the younger adults than that by the older adults (A, V, and AV) in all conditions. In addition, a further comparison of the differences between the probability of audio-visual cumulative distributive functions (CDFs) and race model CDFs showed delayed AVI effects and a longer time window for AVI in older adults than that in younger adults in all conditions. The AVI effect was lower in older adults than that in younger adults during simple meaningless image discrimination (63.0 ms vs. 108.8 ms), but the findings were inverse during semantic image discrimination (310.3 ms vs. 127.2 ms). In addition, there was no significant difference between older and younger adults during semantic character discrimination (98.1 ms vs. 117.2 ms). These results suggested that AVI ability was impaired in older adults, but a compensatory mechanism was established for processing sematic audio-visual stimuli.

scholarly journals Upper eyelid blepharoplasty following hyaluronic acid injection with improved facial aesthetics and eye symptoms: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Luca Maione ◽  
Valeriano Vinci ◽  
Domenico Costanzo ◽  
Andrea Battistini ◽  
Andrea Lisa ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Functional Results ◽  
Facial Aesthetics ◽  
Upper Eyelid ◽  
Age Related ◽  
Outcomes Evaluation ◽  
Patient Reported ◽  
The Face ◽  
Eye Symptoms ◽  
Previously Treated

Abstract Background Dermatochalasis of the upper eyelids (blepharochalasis) is a typical age-related change in the upper third of the face and a major concern for facial aesthetics. Nowadays both surgical and nonsurgical interventions are available for patients complaining of upper eyelid dermatochalasis. Although nonsurgical treatments are often easier to perform, if they are not performed correctly, complications may ensue and worsen the condition. Case presentation We describe the case of a Caucasian patient presenting with bilateral upper eyelid dermatochalasis, previously treated with multiple injections of hyaluronic acid filler. Following these procedures, the patient reported nonspecific eye symptoms (such as a sense of heaviness and asthenopia) and cosmetic concerns. We decided to perform an upper eyelid blepharoplasty. During the procedure we found a ribbon of hard, fibrous material, which was carefully removed. The patient reported resolution of functional eye symptoms owing to the reduction of upper lid heaviness, which also resulted in subjective improvement of the visual field. Patient satisfaction was assessed preoperatively and 3 months postoperatively using the Blepharoplasty Outcomes Evaluation (BOE), which showed an overall satisfaction rate of 95.8 %. Conclusions Blepharoplasty not only treated the patient’s blepharochalasis but also allowed us to correct the previous nonsurgical intervention by removing the excessive amount of injected hyaluronic acid. Both aesthetic and functional results were successfully achieved.

scholarly journals Planning of methods of surgical correction of soft tissues of the face and neck

2021 ◽  
Vol 25 (4) ◽  
pp. 47-52
Author(s):  
S. M. Alimova ◽  
V. I. Sharobaro ◽  
A. V. Telnova ◽  
E. E. Stepanyan
Keyword(s):  
Soft Tissues ◽  
Ultrasound Examination ◽  
Diagnostic Value ◽  
Surgical Correction ◽  
Age Related ◽  
The Face ◽  
Male Patients ◽  
The Mean ◽  
Degree Of Participation

Objective. Role of ultrasound examination in planning surgical correction of age-related changes of the face and neck soft tissues.Methods. A prospective analysis of the study and treatment of 80 patients with involutive changes in the soft tissues of the face and neck who were carried out from 2018 to 2020 in the Mositalmed Clinic. The age of the patients ranged from 24 to 60 years. The mean age was 42 ± 6.89 years (± SE standard deviation mean). There were 67 female patients (83.7%), male patients – 13 (16.3%).Results. The diagnostic value of ultrasound examination in involutional changes in the soft tissues of the face and neck for determining the causes of contour deformities is noted.Conclusion. Ultrasound imaging in an upright position of the patient makes it possible to determine the degree of participation of each tissue in the formation of deformity, which is extremely important for planning various techniques for rejuvenating the face and neck.

scholarly journals SEX AND AGE-RELATED CHANGES IN PERFORMANCE IN THE DUATHLON WORLD CHAMPIONSHIPS

2020 ◽  
Vol 26 (3) ◽  
pp. 234-238
Author(s):  
Oscar Romero-Ramos ◽  
Emilio Fernández-Rodríguez ◽  
Daniel Mayorga-Vega ◽  
Rafael Merino-Marbán ◽  
Robert Podstawski
Keyword(s):  
Female Athletes ◽  
Age Groups ◽  
Performance Ratio ◽  
Age Group ◽  
Level Of Evidence ◽  
Male And Female ◽  
Professional Career ◽  
Age Related ◽  
And Performance ◽  
Retrospective Comparative Study

ABSTRACT Objective Our study analyses differences in performance between sexes, and changes in performance between age groups at Olympic distance during the ITU Duathlon World Championships, held between 2005 and 2016. During this period, a total of 9,772 duathletes were analysed (6,739 men and 3,033 women). Methods Two-way analyses of variance (ANOVA) were used to examine sex- and age-related differences in performance (time, percentage of time and performance ratio) in the first running and cycling legs, the second running leg, and total race for the top 10 male and female athletes in each age group at the Duathlon World Championships. Results The age group with the highest participation, in both male and female categories, was 40-44 years, and it was found that the mean age of female finisher participants across all age groups was 23.5±12. With regards to performance, the best results for total race time and the cycling segment were achieved in the 30-34-year age group, for both male and female athletes. With regards to performance in the first and third segments (running legs), the best times were achieved in the 25-29 and 30-34 age groups, for men and women respectively. Conclusion According to the results of our study, the best results in the professional career of a duathlete are achieved at between 30 and 35 years, therefore the athlete should incorporate this factor into their training plan. Level of evidence III; Retrospective comparative study.

Non-Surgical Correction of Secondary Contour Deformities of the Penile Girth

2021 ◽  
Author(s):  
Yordan P Yordanov
Keyword(s):  
Hyaluronic Acid ◽  
Ambulatory Setting ◽  
The Novel ◽  
Acid Product ◽  
Tissue Integration ◽  
Age Related ◽  
High Satisfaction ◽  
The Mean ◽  
Reliable Solution

Abstract Background Dealing with remaining penilе deformities following corrective surgeries of complications after injection of non-absorbable substаnces tends to be troublesome. To date, there is a lack of adequate information regarding the options for the management of such residual irregularities. In morе than two decades of clinical application, hyaluronic acid fillers have proved to be a safе and reliable solution fоr a great variety of age-related changes, tissue atrophy, and contour deformities. Objectives This brief clinical study aimed to demоnstrate the author’s initial еxperience with the novel use of a hyaluronic acid-based filler for the correction of secondary deformities of the penile girth. Methods Rеtrospective analysis was conducted, encompassing patients who underwent correction of secondary penile deformities with hyaluronic acid between August 2018 and February 2020. Тhe procedures were carried оut in an ambulatory setting and a blunt cannula was used for filler infiltration. A nine-month follow-up was established. Results Five patients aged between 29 and 44 years (with an average of 35.8 years) were found and included in the study. The mean volumе of hyaluronic acid product used for the correction was 3.32 cc. An analysis of the obtained rеsults demonstrated a high satisfaction ratе among pаtients with no complications in thе series. Conclusions The procedure is safe, effective, and relatively simple with reproducible and reliable outcomes. Due to its excellent spreading and good tissue integration, the selected hyaluronic acid filler was very useful in cases where fibrosis was present because of previous surgeries.

Age-related differences in valence and arousal of emotion concepts

2021 ◽  
pp. 1-17
Author(s):  
Radek Trnka ◽  
Josef Mana ◽  
Martin Kuška
Keyword(s):  
Older Adults ◽  
Conceptual Knowledge ◽  
Younger Adults ◽  
Assessment Task ◽  
Age Related ◽  
Younger Men ◽  
The Mean ◽  
Valence And Arousal ◽  
Emotion Concepts ◽  
The Way

Abstract Emotion concepts are representations that enable people to make sense of their own and others’ emotions. The present study, theoretically driven by the conceptual act theory, explores the overall spectrum of emotion concepts in older adults and compares them with the emotion concepts of younger adults. Data from 178 older adults (⩾55 years) and 176 younger adults (20–30 years) were collected using the Semantic Emotion Space Assessment task. The arousal and valence of 16 discrete emotions – anger, fear, sadness, happiness, disgust, hope, love, hate, contempt, guilt, compassion, shame, gratefulness, envy, disappointment, and jealousy – were rated by the participants on a graphic scale bar. The results show that (a) older and younger adults did not differ in the mean valence ratings of emotion concepts, which indicates that older adults do not differ from younger adults in the way they conceptualise how pleasant or unpleasant emotions are. Furthermore, (b) older men rated emotion concepts as more arousing than younger men, (c) older adults rated sadness, disgust, contempt, guilt, and compassion as more arousing and (d) jealousy as less arousing than younger adults. The results of the present study indicate that age-related differentiation of conceptual knowledge seems to proceed more in the way that individuals understand how arousing their subjective representations of emotions are rather than how pleasant they are.

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